Objective: To explore value of treadmill test Duke score on diagnosis of coronary heart disease (CHD). Methods: A total of 200 patients suspected CHD were selected. All patients received biochemical examinations, treadmill exercise test (TET) and coronary angiography (CAG) within two weeks. The results of TET, Duke treadmill score（DTS）and CAG were compared and analyzed. Results: The CAG was regard as gold standard diagnosing CHD. （1）Compared with TET alone, there were significant decrease in specificity (72.3% vs.55.4%, χ2=5.161, P=0.021) in positive DTS alone for diagnosing CHD; there were significant increase in sensitivity(72.6% vs. 87.8%，χ2=7.860, P=0.005), negative predictive value(56% vs.76.9%，χ2=6.128, P=0.013) in combined use of TET and DTS for diagnosing CHD; （2）Compared with positive DTS alone, there were significant increase in sensitivity (76.3% vs. 87.8%，χ2=4.334, P=0.037),negative predictive value(52.9% vs. 76.9%，χ2=7.298, P=0.007) and accuracy (69.5% vs. 80.8%，χ2=5.849, P=0.016)in combined use of TET and DTS. Conclusion: Combined use of treadmill exercise test and Duke score can significantly increase sensitivity, negative predictive value and accuracy diagnosing CHD.

Objective To investigate the correlation factors for hot flashes in climacteric women so as to improve their quality of life. Methods A questionnaire was distributed among 792 climacteric women. The questionnaire items included general information, characteristics of menstruation, reproduction history, information of hot flashes, lifestyle and sexual life. Weight, height, blood pressure, waist and hip circumferences were measured. Logistic regression analysis was made to find out the correlation factors for hot flashes. Results Univariate logistic regression analysis showed that age, education, income, present characteristics of menstruation, dietary habit, soy products intake, physical exercise, satisfaction of sexual life, body mass index (BMI) and systolic blood pressure were significantly associated with hot flashes. Multivariate logistic regression analysis revealed that irregular menstruation or menopause, frequent exercise and higher systolic blood pressure were risk factors for hot flashes in climacteric women. However, higher education, soy products intake and satisfaction of sexual life were protection factors. Conclusion Guiding climacteric women to take moderate physical exercise, knowing more about climacterium, consuming more soy products and controlling diastolic blood pressure are likely to decrease the incidence of hot flashes.

Objective To study the effect of the levels of serum gonadal hormone and plasma calcitonin gene-related peptide(CGRP) on the hot flushes symptom of perimenopausal women. Methods 65 perimenopausal women (35 with hot flushes and 30 without hot flushes) and 25 healthy fertile women were enrolled. The subjects were analyzed for serum estradiol (E2), follicle-stimulating hormone (FSH) ,luteinizing hormone (LH) and plasma calcitonin gene-related peptide (CGRP). Results. ① There were no significant differences of the E2 levels between the perimenopausal women with and without hot flushes (P>0.05). The levels of FSH and LH were significantly higher in the women with hot flushes than women without hot flushes and fertile women(P<0.05),② The levels of plasma CGRP were significantly higher in the women with hot flushes than women without hot flushes (P<0.05), and significantly lower than fertile women,③The levels of plasma CGRP were significantly higher in severe hot flu-shes group than that in the mild hot flushes group and moderate hot flushes group(P<0.05), the severity of hot flu-shes was positively related to the level of plasma CGRP(rs=0.823, P<0.01), but there was no relationship be-tween serum E2 and the severity of hot flushes (P>0.05). Conclusion The occurrence of perimenopansal hot flu-shes might be closely related to the decline and fluctuation of serum E2,increase of FSH and LH and the concentra-tion variety of plasma CGRP.

Objective To evaluate the efficacy and safety of intravitreal ranibizumab injection combined with triamcinolone acetonide (TA) for macular edema secondary to type Ⅱ optic disc vasculitis.Methods Totally 19 cases(19 eyes) with macular edema secondary to type Ⅱ optic disc vasculitis from January 2013 to December 2015 were injected ranibizumab intravitreally and triamcinolone acetonide 2 weeks later.The visual acuity,intraocular pressure,ocular fundus,OCT,FFA and related complications were observed during the 6 months follow-up period.If the macuiar edema returns during the follow-up period,the eyes would be given ranibizumab and TA again until the macular edema subsided.Results The visual acuity was 0.16 ± 0.09 and the central retinal thickness was (694.88 ± 79.06) μm before treatment.Compared with pretreatment,the visual acuity of all cases were improved in different degree except for one at 1 month,3 months and 6 months (all P ＜ 0.05).Also central retinal thickness were decreased and macular edema were subsided,there were statistical differences (all P ＜0.05).Compared with results at 1 month,the visual acuity and central retinal thickness was no significant different at 3 months and 6 months (all P ＞ 0.05).The intraocular pressure of all cases were normal throughout the follow-up period but one was increased transitorily in the first day after intravitreal rauibizumab injection.FFA examination at 1 month showed retinal hemorrhage and effusion absorbed obviously,besides,the optic disc and macular fluorescein leakage reduced significantly.The macular edema of 1 eye returned at 3 months and subsided after giving ranibizumab and TA again.The average number of injected eyes was 2.11 times.No complications associated with intravitreal injection and drugs were observed during the follow-up period.Conclusion It is effective and safe that intravitreal ranibizumab junction combined with TA for macular edema secondary to type Ⅱ optic disc vasculitis,which not only shorten the period of treatment but also reduce the times of drug injection,surgical trauma and complications.

Objective To investigate the safety and effectiveness of open radical prostatectomy (ORP) for locally advanced prostate cancer (LAPC).Methods From January 2012 to April 2017,132 cases underwent ORP were included.The mean age was 65.1 years old (ranged 41 to 83 years old),median PSA was 28.9 ng/ml (ranged 1.2 to 319.7 ng/ml) and mean Glcason score was 8.0(ranged 6.0 to 10.0).The number of clinical stage T3aN0,T3bN0,T4N0 and T1 ～4N1 were 92 cases(69.7％),20 cases (15.2％),8 cases (6.1％) and 12 cases (9.0％),respectively.Results The median length of hospital day,mean operative time and median blood loss were 9 d,180 min and 350 ml respectively.The intraoperative complication rate was 3.0％ (4/132),including 2 rectum injury and 2 iliac vessel injury.Pathological tumor stage revealed that ≤ pT2 N0 7 cases (5.3％),pT3a N0 61 cases (46.2％),pT3b N0 38 cases (28.8％),pT4N0 12 cases (9.1％) and pT1～4N1 14 cases (10.6％).The mean Gleason score was 8.0 (ranged 6 tol0).The numbers of patients with perineural invasion,seminal vesicle invasion and positive surgical margin were 81 cases (61.4％),49 cases (37.1％) and 41 cases (31.1％) respectively.The median follow-up duration was 24.1 (ranged 1.8 to 62.2) months.The rate of postoperative complications was 3.0％ (4/132) including 1 urethral stricture,1 wound infection,1 intestinal fistula and 1 lymphatic fistula.The rates of patients with urinary continence 1,3,6 and 12 months after surgery were 30.4％ (38/125)、63.9％ (76/119)、72.6％ (82/112)、89.1％ (90/101).The rates of adjuvant hormonal therapy and radiotherapy were 34.1％ (45/132) and 38.6％ (51/132).One patient (0.8％) died of lung cancer.The rate of biochemical recurrence(BCR) was 25.8％ (34/132).The 5-year BCRfree survival rate was 57.2％ (95％ CI 41.9％ ～ 70.6％).Conclusion The oncological control and functional recovery outcomes of ORP for locally advanced prostate cancer were reliable.

Objective: To learn the epidemiological characteristics of fall mortality among the elderly people in Taizhou，and to provide basis for intervention strategies of fall in the elderly. Methods: Data of fall mortality among residents aged 60 years or over in Taizhou from 2016 to 2018，collected from Zhejiang Chronic Disease Surveillance Information Management System，was used for analysis of time，population and geographical characteristics of fall deaths. The epidemic trend of fall mortality in the elderly was described by annual percentage change（APC）. Results: From 2016 to 2018，3 699 cases of fall death in Taizhou were reported，the crude and standardized mortality were 116.90/100 000 and 97.88/100 000. The standardized mortality of fall in women was 106.11/100 000，which was higher than 90.13/100 000 in men（P<0.05）. The standardized mortality of fall in rural residents was 131.20/100 000，which was higher than 28.15/100 000 in urban residents（P<0.05）. The mortality of fall in residents aged 65-69 years from 2016 to 2018 showed an upward trend（APC=4.20%，P<0.05），while the mortality trend of fall in other age groups was not statistically significant（P>0.05）. Conclusion Fall was the first cause of injury death in the elderly aged 60 years or over in Taizhou. Females and rural residents have relatively higher fall mortality.

Objective: This study aims to explore the relationships of family functioning, general well-being, and exercise with psychological distress.Furthermore, we investigated the special roles of general well-being and exercise on the association between family functioningand psychological distress. Methods: Of 769 end-stage renal disease (ESRD) patients participated in the cross-sectional study which consisted of the 12-item GeneralHealth Questionnaire (GHQ-12), the Family APGAR Scales, and the General Well-Being Schedule. The collected data were analyzedusing multiple linear regression analysis and path analysis. Results: The prevalence of psychological distress was 72.3%. Family functioning, general well-being and exercise were associated factorsof psychological distress (p<0.05). The indirect effect of family functioning on psychological distress was partially mediated by generalwell-being (Effect=-0.08, 95% CI=-0.11, -0.04). In addition, the effect of family functioning on general well-being was moderated byexercise (Index=-0.092, SE=0.033, 95% CI=-0.159, -0.029). Conclusion The prevalence of psychological distress among ESRD patients was high. Family functioning, general well-being and exercisewere associated with psychological distress. Family functioning could affect psychological distress partially by affecting general wellbeing.Furthermore, exercise had a significant moderating effect on the relationship between family functioning and general well-being.Psychiatry Investig 2020;17(4):356-365

BACKGROUND: Most Chinese migrants have been faced with obstacles to getting access to local public health services. Young migrants among internal migrants make a major contribution to the economy. However, the establishment of their health records has been ignored. This research was aimed at exploring the status and associated factors of the establishment of health records among young Chinese migrants. METHODS: Data were obtained from the 2017 China Migrants Dynamic Survey (CMDS). Chi-square test and binary logistic regression were performed to investigate the associated factors of the establishment of health records among young Chinese migrants. RESULTS: Approximately 30.2% of young migrants had their health records established in inflow communities. Urban residence, medical insurance (insured), and lower average monthly household income were attributed to the establishment of more health records. Young migrants who were in northeast China and across provinces and immigrated for working or engaging in trade were less likely to have health records established. Young migrants who participated in social activities and public affairs activities and took type of people in touch as natives in the inflow area showed a higher possibility of establishing health records. Meanwhile, receiving health education and hearing about national basic public health services (BPHSs) were beneficial for establishing the health records of more young migrants. CONCLUSION This study showed that the health records of young migrants had a relatively low establishment rate. Sociodemographic and migration characteristics, health status, public health services, and social integration factors were all related to the health record establishment of young Chinese migrants.
Adolescent ; Adult ; China ; Female ; Health Records, Personal ; Humans ; Male ; Transients and Migrants/statistics & numerical data* ; Young Adult

BACKGROUND: Limited published research has examined the relationships of negative life events and coping styles with sleep quality in Chinese junior high school students. We aimed to investigate the prevalence of poor sleep quality and to clarify the role of coping styles between negative life events and sleep quality. METHODS: A cross-sectional study of 3081 students was conducted in Ganzhou City, Jiangxi Province, Southeastern China. Adolescent Self-Rating Life Events Checklist, Simplified Coping Style Questionnaire, and Pittsburg Sleep Quality Index were applied to assess negative life events, coping styles, and sleep quality, respectively. Descriptive analyses, independent-samples t tests, one-way analyses of variance, Pearson correlation analyses, and structural equation modeling (SEM) were applied to analyze the data. RESULTS: The prevalence of poor sleep quality was 26.7%. Negative life events (B = 0.038, P < 0.001) and negative coping style (B = 0.049, P < 0.001) demonstrated a positive association with poor sleep quality, while positive coping style indicated a negative association with poor sleep quality (B = -0.029, P < 0.001). Interactions of negative life events and coping styles with sleep quality were not found (all P > 0.05). The association between negative life events and sleep quality was mediated by negative coping styles. CONCLUSIONS Our results indicated that poor sleep quality was common in these Chinese adolescents. Negative life events and negative coping style were associated with an increased prevalence of poor sleep quality, while the positive coping style was related to a decreased prevalence of poor sleep quality. A negative coping style mediated the association between negative life events and sleep quality.
Adaptation, Psychological ; Adolescent ; Child ; China ; Cross-Sectional Studies ; Humans ; Life Change Events ; Psychology, Adolescent ; Psychology, Child ; Sleep

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.